MinisymposiumPublic health gains from health in prisons in Spain
Section snippets
The context: the social and health environment
The impressive results achieved by prison health in Spain in its fight against the most common communicable diseases in prisons can be best understood if the history of health services in prison is known. Until the 19th century there was not a real medical care system in prisons. Until then, the ‘custody prison’ prevailed, holding those to go before the relevant Court and there was a range of punishments such as whipping, mutilation and even the death sentence.
Health within the prison setting
The HIV/AIDS epidemic
Although detached from community health services, the prison health services developed progressively through the 1980s. Part of the evolution was a consequence of one of the modern pandemics capable of achieving a high prevalence in prison settings, namely HIV/AIDS. This infection, closely related to drug abuse by injection, was widely spread amongst prisoners due to the high rates of injecting drug use in prisons. Within WHO, a Consultation Statement on the Prevention and the Fight against
Prison populations
Generally, the population within European prisons is made up of people from the most vulnerable social sectors with a high risk of social exclusion and poverty. People under confinement usually have worse physical and mental health than the general population. Their lifestyles have usually implied the risk of suffering certain diseases, many of them communicable. Many of them have never or rarely had contact with health services prior to their imprisonment. Mental disorders, drug abuse and
Results and remaining challenges
From the registry, we have noticed the following:
- 1.
There has been an obvious reduction trend in the infection by HIV during the last few years, so that the current prevalence is almost 3.5 times lower than that recorded in 1994 (Fig. 1);
- 2.
the incidence of AIDS has been reduced by 16% since 1995, the year the current fall started;
- 3.
the parenteral route is the main route in diagnosed cases in prison although that has fallen by 16% since 1991; this has been achieved at the expense of an increase in
Ethical approval
None required.
Funding
None declared.
Competing interests
None declared.
References (2)
- et al.
Calidad asistencial en sanidad penitenciana en España
(May 2010) Bolentín Epidemiológico de Instituciones Penitenciarias
(November–December 2009)
Cited by (5)
Public health and international drug policy
2016, The LancetCitation Excerpt :Spain's experience illustrates the synergistic impact of combined interventions. The frank recognition in Spain of extensive drug use within prison walls led to the establishment of both OST and NSPs in the prison service.413 ART was provided in prison.
Availability, Accessibility, and Coverage of Needle and Syringe Programs in Prisons in the European Union
2020, Epidemiologic ReviewsTrend of HIV/AIDS prevalence and related interventions administered in prisons of Iran -13 years' experience
2014, Iranian Journal of Public HealthPrison medicine, public health policy and ethics: The Geneva experience
2011, Swiss Medical WeeklyEvolution of the prison population mortality after introduction Antiretroviral Therapy (ART)
2011, Revista Espanola de Salud Publica